Dataset Information

Ambient air pollution and daily outpatient visits for cardiac arrhythmia in Shanghai, China.

ABSTRACT:

Background

Cardiac arrhythmias are cardiac rhythm disorders that comprise an important public health problem. Few prior studies have examined the association between ambient air pollution and arrhythmias in general populations in mainland China.

Methods

We performed a time-series analysis to investigate the short-term association between air pollution (particulate matter with an aerodynamic diameter less than 10 µm [PM10], sulfur dioxide [SO2], and nitrogen dioxide [NO2]) and outpatient visits for arrhythmia in Shanghai, China. We applied the over-dispersed Poisson generalized additive model to analyze the associations after control for seasonality, day of the week, and weather conditions. We then stratified the analyses by age, gender, and season.

Results

We identified a total of 56 940 outpatient visits for cardiac arrhythmia. A 10-µg/m3 increase in the present-day concentrations of PM10, SO2, and NO2 corresponded to increases of 0.56% (95% CI 0.42%, 0.70%), 2.07% (95% CI 1.49%, 2.64%), and 2.90% (95% CI 2.53%, 3.27%), respectively, in outpatient arrhythmia visits. The associations were stronger in older people (aged ?65 years) and in females. This study provides the first evidence that ambient air pollution is significantly associated with increased risk of cardiac arrhythmia in mainland China.

Conclusions

Our analyses provide evidence that the current air pollution levels have an adverse effect on cardiovascular health and strengthened the rationale for further limiting air pollution levels in the city.

SUBMITTER: Zhao A

PROVIDER: S-EPMC4074637 | biostudies-literature | 2014

REPOSITORIES: biostudies-literature

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Publications

Ambient air pollution and daily outpatient visits for cardiac arrhythmia in Shanghai, China.

Zhao Ang A Chen Renjie R Kuang Xingya X Kan Haidong H

Journal of epidemiology 20140517 4

<h4>Background</h4>Cardiac arrhythmias are cardiac rhythm disorders that comprise an important public health problem. Few prior studies have examined the association between ambient air pollution and arrhythmias in general populations in mainland China.<h4>Methods</h4>We performed a time-series analysis to investigate the short-term association between air pollution (particulate matter with an aerodynamic diameter less than 10 µm [PM10], sulfur dioxide [SO2], and nitrogen dioxide [NO2]) and outp ...[more]

PMID: 24835409

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Project description:BACKGROUND:Arrhythmia is a common cardiovascular event that is associated with increased cardiovascular health risks. Previous studies that have explored the association between air pollution and arrhythmia have obtained inconsistent results, and the association between the two in China is unclear. METHODS:We collected daily data on air pollutants and meteorological factors from 1st January 2014 to 31st December 2016, along with daily outpatient visits for arrhythmia in Hangzhou, China. We used a quasi-Poisson regression along with a distributed lag nonlinear model to study the association between air pollution and arrhythmia morbidity. RESULTS:The results of the single-pollutant model showed that each increase of 10??g/m3 of Fine particulate matter (PM2.5), Coarse particulate matter (PM10), Sulphur dioxide (SO2), Nitrogen dioxide (NO2), and Ozone (O3) resulted in increases of 0.6% (-?0.9, 2.2%), 0.7% (-?0.4, 1.7%), 11.9% (4.5, 19.9%), 6.7% (3.6, 9.9%), and?-?0.9% (-?2.9, 1.2%), respectively, in outpatient visits for arrhythmia; each increase of 1?mg/m3 increase of carbon monoxide (CO) resulted in increase of 11.3% (-?5.9, 31.6%) in arrhythmia. The short-term effects of air pollution on arrhythmia lasted 3?days, and the most harmful effects were observed on the same day that the pollution occurred. Results of the subgroup analyses showed that SO2 and NO2 affected both men and women, but differences between the sexes were not statistically significant. The effect of SO2 on the middle-aged population was statistically significant. The effect of NO2 was significant in both the young and middle-aged population, and no significant difference was found between them. Significant effects of air pollution on arrhythmia were only detected in the cold season. The results of the two-pollutants model and the single-pollutant model were similar. CONCLUSIONS:SO2 and NO2 may induce arrhythmia, and the harmful effects are primarily observed in the cold season. There is no evidence of PM2.5, PM10, CO and O3 increasing arrhythmia risk. Special attention should be given to sensitive populations during the high-risk period.

Project description:An accident is an unwanted hazard to a person. However, accidents occur. In this work, we search for correlations between daily accident rates and environmental factors. To study daily hospital outpatients who were admitted for accidents during a 5-year period, 2007-2011, we analyzed data regarding 168,366 outpatients using univariate regression models; we also used multivariable regression models to account for confounding factors. Our analysis indicates that the number of male outpatients admitted for accidents was approximately 1.31 to 1.47 times the number of female outpatients (P < 0.0001). Of the 12 parameters (regarding air pollution and meteorology) considered, only daily temperature exhibited consistent and significant correlations with the daily number of hospital outpatient visits for accidents throughout the 5-year analysis period. The univariate regression models indicate that older people (greater than 66 years old) had the fewest accidents per 1-degree increase in temperature, followed by young people (0-15 years old). Middle-aged people (16-65 years old) were the group of outpatients that were more prone to accidents, with an increase in accident rates of 0.8-1.2 accidents per degree increase in temperature. The multivariable regression models also reveal that the temperature variation was the dominant factor in determining the daily number of outpatient visits for accidents. Our further multivariable model analysis of temperature with respect to air pollution variables show that, through the increases in emissions and concentrations of CO, photochemical O3 production and NO2 loss in the ambient air, increases in vehicular emissions are associated with increases in temperatures. As such, increases in hospital visits for accidents are related to vehicular emissions and usage. This finding is consistent with clinical experience which shows about 60% to 80% of accidents are related to traffic, followed by accidents occurred in work place.

Project description:The Eastern Economic Corridor in Thailand is undergoing development, but industrial activities are causing serious air pollution. This study aimed to examine the effects of particulate matter (PM10), fine particulate matter (PM2.5), SO2, NO2, O3, and CO on outpatient department (OPD) visits and mortality with various causes in the Eastern Economic Corridor, Thailand between 2013 and 2019 using a case-crossover design and conditional Poisson model. The corresponding burden of disease due to air pollution exposure was calculated. A 1 µg/m3 increase in the PM10 was associated with significant increases in OPD visits for circulatory diseases (0.22, 95% CI 0.01, 0.34), respiratory diseases (0.21, 95% CI 0.13, 0.28), and skin and subcutaneous tissue diseases (0.18, 95% CI 0.10, 0.26). By contrast, a 1 µg/m3 increase in the PM10 was associated with significant increases in mortality from skin and subcutaneous tissue diseases (0.79, 95% CI 0.04, 1.56). A 1 µg/m3 increase in PM2.5 was associated with significant increases in mortality from circulatory diseases (0.75, 95% CI 0.20, 1.34), respiratory diseases (0.82, 95% CI 0.02, 1.63), and skin and subcutaneous tissue diseases (2.91, 95% CI 0.99, 4.86). The highest OPD burden was for circulatory diseases. Respiratory effects were attributed to PM10 exceeding the national ambient air quality standards (NAAQS) of Thailand (120 μg/m3). The highest morbidity burden was for skin and subcutaneous tissue diseases attributed to PM2.5 concentrations that exceeded the NAAQs (50 μg/m3). PM pollution in the EEC could strongly contribute to OPD visits and morbidity from various diseases. Preventing PM10 concentrations from being higher than 60 µg/m3 could decrease OPD visits by more than 33,265 and 29,813 for circulatory and respiratory diseases, respectively. Our study suggests that such pollution increases the risks of OPD visits and mortality in various causes in the Thai EEC. Reducing the ambient air pollution concentration of NAAQSs in Thailand could reduce the health effect on the Thai population.

Project description:BackgroundThe systematic evaluation of the results of time-series studies of air pollution is challenged by differences in model specification and publication bias.MethodsWe evaluated the associations of inhalable particulate matter (PM) with an aerodynamic diameter of 10 ?m or less (PM10) and fine PM with an aerodynamic diameter of 2.5 ?m or less (PM2.5) with daily all-cause, cardiovascular, and respiratory mortality across multiple countries or regions. Daily data on mortality and air pollution were collected from 652 cities in 24 countries or regions. We used overdispersed generalized additive models with random-effects meta-analysis to investigate the associations. Two-pollutant models were fitted to test the robustness of the associations. Concentration-response curves from each city were pooled to allow global estimates to be derived.ResultsOn average, an increase of 10 ?g per cubic meter in the 2-day moving average of PM10 concentration, which represents the average over the current and previous day, was associated with increases of 0.44% (95% confidence interval [CI], 0.39 to 0.50) in daily all-cause mortality, 0.36% (95% CI, 0.30 to 0.43) in daily cardiovascular mortality, and 0.47% (95% CI, 0.35 to 0.58) in daily respiratory mortality. The corresponding increases in daily mortality for the same change in PM2.5 concentration were 0.68% (95% CI, 0.59 to 0.77), 0.55% (95% CI, 0.45 to 0.66), and 0.74% (95% CI, 0.53 to 0.95). These associations remained significant after adjustment for gaseous pollutants. Associations were stronger in locations with lower annual mean PM concentrations and higher annual mean temperatures. The pooled concentration-response curves showed a consistent increase in daily mortality with increasing PM concentration, with steeper slopes at lower PM concentrations.ConclusionsOur data show independent associations between short-term exposure to PM10 and PM2.5 and daily all-cause, cardiovascular, and respiratory mortality in more than 600 cities across the globe. These data reinforce the evidence of a link between mortality and PM concentration established in regional and local studies. (Funded by the National Natural Science Foundation of China and others.).

Project description:BackgroundAir pollution disparities by socioeconomic status (SES) are well documented for the United States, with most literature indicating an inverse relationship (i.e., higher concentrations for lower-SES populations). Few studies exist for China, a country accounting for 26% of global premature deaths from ambient air pollution.ObjectiveOur objective was to test the relationship between ambient air pollution exposures and SES in China.MethodsWe combined estimated year 2015 annual-average ambient levels of nitrogen dioxide (NO2) and fine particulate matter [PM ≤2.5μm in aerodynamic diameter (PM2.5)] with national demographic information. Pollution estimates were derived from a national empirical model for China at 1-km spatial resolution; demographic estimates were derived from national gridded gross national product (GDP) per capita at 1-km resolution, and (separately) a national representative sample of 21,095 individuals from the China Health and Retirement Longitudinal Study (CHARLS) 2015 cohort. Our use of global data on population density and cohort data on where people live helped avoid the spatial imprecision found in publicly available census data for China. We quantified air pollution disparities among individual's rural-to-urban migration status; SES factors (education, occupation, and income); and minority status. We compared results using three approaches to SES measurement: individual SES score, community-averaged SES score, and gridded GDP per capita.ResultsAmbient NO2 and PM2.5 levels were higher for higher-SES populations than for lower-SES population, higher for long-standing urban residents than for rural-to-urban migrant populations, and higher for the majority ethnic group (Han) than for the average across nine minority groups. For the three SES measurements (individual SES score, community-averaged SES score, gridded GDP per capita), a 1-interquartile range higher SES corresponded to higher concentrations of 6-9 μg/m3 NO2 and 3-6 μg/m3 PM2.5; average concentrations for the highest and lowest 20th percentile of SES differed by 41-89% for NO2 and 12-25% for PM2.5. This pattern held in rural and urban locations, across geographic regions, across a wide range of spatial resolution, and for modeled vs. measured pollution concentrations.ConclusionsMultiple analyses here reveal that in China, ambient NO2 and PM2.5 concentrations are higher for high-SES than for low-SES individuals; these results are robust to multiple sensitivity analyses. Our findings are consistent with the idea that in China's current industrialization and urbanization stage, economic development is correlated with both SES and air pollution. To our knowledge, our study provides the most comprehensive picture to date of ambient air pollution disparities in China; the results differ dramatically from results and from theories to explain conditions in the United States. https://doi.org/10.1289/EHP9872.

Dataset Information

Ambient air pollution and daily outpatient visits for cardiac arrhythmia in Shanghai, China.

Background

Methods

Results

Conclusions

Publications

Ambient air pollution and daily outpatient visits for cardiac arrhythmia in Shanghai, China.

Similar Datasets

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